Successful treatment of twin-twin transfusion syndrome by occlusion of placental vessel anastomoses using enbucrilate.
OBJECTIVE
Twin-twin transfusion syndrome is a serious obstetric complication unique to monochorionic twin gestations. Occlusion of vessel anastomoses is recommended to improve the perinatal outcome.


METHODS
A 36-year-old, gravida 1, woman had a monochorionic twin pregnancy which was found to be affected by twin-twin transfusion syndrome at 26 weeks' gestation. The condition was successfully treated by occlusion of placental vessel anastomoses using enbucrilate under color Doppler ultrasonographic guidance. At 35 weeks of gestation, two male infants were delivered by cesarean section. The birth weights of the babies were 2,470 and 1,750 g, and both were thriving.


CONCLUSIONS
Targeted therapeutic ablation of vessel anastomoses involved in twin-twin transfusion syndrome using color Doppler ultrasonographic guidance is minimally invasive and may effectively obliterate interfetal transfusion, contributing to the survival of both twins.
Yang
Ting-Yu
TY
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, and Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
Huang
Shang-Yu
SY
Shaw
Sheng-Wen
SW
Cheng
Po-Jen
PJ
Chueh
Ho-Yen
HY
Soong
Yung-Kuei
YK
D000328:Adult; D002585:Cesarean Section; D004621:Embolization, Therapeutic / Q000379:methods; D004659:Enbucrilate / Q000627:therapeutic use*; D005260:Female; D005330:Fetofetal Transfusion / Q000000981:diagnostic imaging* / Q000628:therapy*; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010920:Placenta / Q000098:blood supply*; D021041:Placental Circulation / Q000502:physiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011295:Prenatal Care / Q000379:methods; D018570:Risk Assessment; D014430:Twins, Monozygotic; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional; D016216:Ultrasonography, Prenatal
D004659:Enbucrilate